Endoscope with inertial measurement units and/or haptic input controls

ABSTRACT

An endoscope having an insertion tube with a distal optical module and a releasable handle. In a semi-robotic embodiment, the handle comprises haptic controllers and a computer configured for steering and/or adjusting physical properties of the insertion tube in response to one or more command inputs from the haptic controllers. The computer may also convert image data received from the optical module into two-dimensional images displayable on a monitor. The endoscope may have inertial measurement units (IMUs) for providing data to the computer for creating a digital three-dimensional image representation of an anatomy model and/or for facilitating handling properties of the endoscope.

CROSS-REFERENCE TO RELATED APPLICATION(S)

The present application claims priority to U.S. Provisional PatentApplication No. 62/740,314, titled “FLEXIBLE ENDOSCOPE WITH INERTIALMEASUREMENT UNITS,” filed Oct. 2, 2018, the disclosure of which ishereby incorporated by reference in its entirety.

TECHNICAL FIELD

The present disclosure relates generally to endoscopes and associatedsystems and methods.

BACKGROUND

An endoscope is an illuminated optical, typically slender and tubularinstrument used to look deep into the body. A flexible endoscope has aflexible insertion tube with a distal segment that can be controllablydeflected by tensioning control cables to navigate thesometimes-tortuous pathways through the body. An endoscope may bedesigned for use in particular diagnostic or therapeutic endoscopyprocedures, and is named accordingly, for example gastrointestinalendoscope, duodenoscope, bronchoscope, cystoscope, ureteroscope, orhysteroscope.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a partially schematic view of a proximal portion of anendoscope in accordance with embodiments of the present technology.

FIG. 2 shows a longitudinal cross-sectional and partially schematic viewof a distal portion of an endoscope in accordance with embodiments ofthe present technology.

FIG. 3 is a transverse cross-sectional view of the distal portion of theendoscope of FIG. 2 , taken along line 3-3.

FIG. 4 shows another longitudinal cross-sectional and partiallyschematic view of a distal portion of an endoscope in accordance withembodiments of the present technology.

FIG. 5 is a side view of an insertion tube in accordance with anotherembodiment of the present technology. The outer sheath is omitted forclarity.

FIG. 6 is a transverse cross-sectional view of the insertion tube ofFIG. 5 , taken along line 6-6.

FIG. 7 is an isometric view of the distal end of the insertion tube ofFIG. 5 .

FIG. 8 is a cutaway drawing of the intermediate segment of the insertiontube of FIG. 5 . Tubular working channels and control cables are omittedfor clarity.

FIG. 9 is an isometric view of the distal end of the insertion tube ofFIG. 5 . The outer sheath, tubular working channels and control cablesare omitted for clarity.

DETAILED DESCRIPTION

The present disclosure relates generally to endoscopes and associatedsystems and methods. Specific details of several embodiments of thepresent technology are described herein with reference to FIGS. 1-4 .Although many of the embodiments are described with respect to endoscopedevices, systems, and methods, other embodiments in addition to thosedescribed herein are within the scope of the present technology. Itshould be noted that other embodiments in addition to those disclosedherein are within the scope of the present technology. Further,embodiments of the present technology can have different configurations,components, and/or procedures than those shown or described herein.Moreover, a person of ordinary skill in the art will understand thatembodiments of the present technology can have configurations,components, and/or procedures in addition to those shown or describedherein and that these and other embodiments can be without several ofthe configurations, components, and/or procedures shown or describedherein without deviating from the present technology.

As used herein, the terms “distal” and “proximal” define a position ordirection with respect to a clinician or a clinician's control device(e.g., a handle of an endoscope). The terms, “distal” and “distally”refer to a position distant from or in a direction away from a clinicianor a clinician's control device along the length of device. The terms“proximal” and “proximally” refer to a position near or in a directiontoward a clinician or a clinician's control device along the length ofdevice. The headings provided herein are for convenience only and shouldnot be construed as limiting the subject matter disclosed.

As shown in FIGS. 1-4 , an endoscope system 10 includes a flexibleendoscope 15, a computer 16, and a monitor 17. Monitor 17 is locatedseparately from or extrinsic to endoscope 15 and communicationtherebetween may be wireless (e.g. WLAN, WPAN radio networks) or via anelectrical cable or data port 18 as indicated by broken lines in FIG. 1. Endoscope 15 includes an elongate assembly having a distal regionconfigured for insertion into a living body, the entire assemblyreferred to herein as a flexible elongate insertion tube 20.

An optical module 22 is disposed at distal end 21 of insertion tube 20and is adapted to receive images of an interior of a hollow organ orother targeted cavity of a living body. Optical module 22 can beselected from various configurations, none of which is shown. In a firstconfiguration, optical module 22 comprises an outer casing, a lens orlens assembly, a PCB containing a camera chip and a connector that maybe directly mounted on the PCB or attached to the PCB via a flexibleelectrical cable. In this configuration, an illumination source isseparate from the optical module and must be integrated elsewhere intothe endoscope body. In a second configuration, optical module 22comprises an outer casing, a lens or lens assembly, an LED lightingsystem, a PCB containing a camera chip and a connector that may bedirectly mounted on the PCB or attached to the PCB via a flexibleelectrical cable. Alternatively, more than one optical module 22 may bemounted at distal end 21 of insertion tube 20.

Insertion tube 20 also includes one or more distal inertial measurementunits (IMUs) 25 disposed at tube distal end 21. IMUs 25 may beincorporated into optical module 22 or mounted separately therefrom, asillustrated in FIG. 2 . As shown in FIG. 5 and described below, anintermediate IMU 27 may also be disposed at the proximal end of distalsegment 50. An inertial measurement unit is an electronic device thatmeasures and reports an object's specific acceleration, angular rate,and magnetic field surrounding the object, using a combination ofaccelerometers, gyroscopes, and magnetometers. An IMU works by detectinglinear acceleration, rotational rate, and heading reference. Whenapplied to each axis, an IMU can provide pitch, roll, and yaw as well aslinear movement. When incorporated into Inertial Navigation Systems, theraw IMU measurement data are utilized to calculate attitude, angularrates, linear velocity and position relative to a global referenceframe. IMU data allows a computer to track an object's position, using amethod known as dead reckoning or the process of calculating one'scurrent position by using a previously determined position, or fix, andadvancing that position based upon known or estimated speeds overelapsed time and course. IMU navigation can suffer accuracy limitationsfrom accumulated error or drift. This error is expected to be reduced inthe present technology by combining IMU data with image data generatedby optical module 22 such that each subsequent image serves as both anew and a cumulative navigational reference. Associating each imageframe or a sampling of image frames with a discrete distal IMU pose datapoint to create a discrete image pose datum is expected to allownavigation errors to be removed.

As shown in FIGS. 3 and 4 , a plurality of control cables 30 extendproximally through insertion tube 20 from corresponding anchor points 31at insertion tube distal end 21. As will be understood by a person ofordinary skill in the field of endoscopes, cables 30 may be tensionedsingly or in various combinations to alter the shape and/or torsional orbending stiffness of insertion tube 20 to facilitate navigating thesometimes-tortuous pathways through the living body. Actuators forapplying tension to cables 30 are described below.

Optionally, insertion tube 20 may include one or more working channel(s)35 therethrough for delivery of fluids or tools as will be understood bya person of ordinary skill in the field of endoscopes.

FIGS. 5-9 illustrate another embodiment of an insertion tube 20′ inaccordance with the present technology. Insertion tube 20′ includes,listed from distal end to proximal end, distal tip 21, distal segment50, intermediate segment 52, strain relief segment 54, and proximal endconnector 39. In a flexible endoscope embodiment, distal segment 50 maycomprise a bendable active segment, and intermediate segment 52 may be aflexible segment. An outer sheath 56, shown in FIG. 6 but omitted fromFIG. 5 for clarity, encloses all the components of insertion tube 20′located distal of connector 39 except for the distal end 23 of insertiontube 20′, where optical module 22 is exposed as shown in FIG. 7 .

Insertion tube 20′ also includes elongate inner tube 60 with electricalwires 61 extending therethrough from connector 39 to, e.g. opticalmodule 22 and IMUs 25, 27. Inner tube 60 is surrounded by elongate spine62, which has one or more channel grooves 64 configured to receive oneor more corresponding tubular working channels 35. See FIGS. 6 and 8 .Channel grooves 64 extend longitudinally parallel to a centerline ofspine 62 along flexible intermediate segment 52 and bendable activesegment 50. In the exemplary embodiment, four working channels 35 a-cextend from a side port in connector 39 to insertion tube distal end 23,and are confined to channel lumens 66 defined between channel grooves 64of spine 62 and outer sheath 56.

Spine 62 has a plurality of cable grooves 68 configured to receive oneor more corresponding cables 30. See FIGS. 6 and 8 . Cable grooves 68are helical along flexible intermediate segment 52 and extendlongitudinally parallel to a centerline of spine 62 along bendableactive segment 50. In the exemplary embodiment, four cables 30 extendfrom connector 39 to insertion tube distal tip 21, and are confined tocable lumens 72 defined between cable grooves 68 of spine 62 and outersheath 56. A first and second pair of 180 degree opposed helical cablegrooves 68 have reverse chirality or handedness such that the first andsecond pair of grooves 68 intersect or cross each other repeatedly alongflexible intermediate segment 52. For example, cables 30 a and 30 cextend through respective cable lumens 72 of spine 62 to define acongruent double right-handed helix and cables 30 b and 30 d extendthrough respective cable lumens 72 of spine 62 to define a congruentdouble left-handed helix. Each pair of cable lumens 72, e.g. lumenscarrying cables 30 a and 30 c, remains opposed 180 degrees alongflexible intermediate segment 52 and bendable active segment 50 tobalance tension forces and to define an orthogonal bending plane withinactive segment 50. At least at distal end 21, cables 30 a and 30 c arespaced 90 degrees from cables 30 b and 30 d to provide at least twoorthogonal planes of bending in active segment 50. Since all cablegrooves 72 are formed in spine 62 at the same radius from the center ofspine 62, cables 30 may have sliding contact with each other where theyintersect. Cables 30 extend proximally from corresponding anchor points31 (see FIG. 4 ) to connector 39. As shown in FIG. 5 , cables 30 aredisposed around, i.e. outside of working channels 35. However, it isalso an embodiment of the current technology for the spine grooves to beconfigured such that the working channels 35 are disposed outside of thecables 30.

Bendable active segment 50 is configured to be sufficiently flexible tobe deflectable in any direction in response to combinations oftensioning in control cables 30, as shown in FIG. 9 . Flexibleintermediate segment 52 may include intermediate IMU 27 disposed at thedistal end thereof, and is less flexible than active segment 50.However, the torsional or bending stiffness of intermediate segment 52can be controllably increased, for example, by simultaneously tensioningall cables 30. Thus, the torsional or bending stiffness of intermediatesegment 52 can be altered regardless of the straight or deflected shapeof active segment 50. Conversely, active segment 50 can be controllablydeflected independently of the stiffness that may have been induced intointermediate segment 52. Optional strain relief segment 54 may beprovided to further increase inherent stiffness and kink-resistance atthe proximal end of insertion tube 20′. Strain relief segment 54 maycomprise a spiral or helical coil of suitable metal or polymer, and maybe disposed either inside or outside of cables 30, and either inside oroutside of outer sheath 56. Outer sheath 56 encases all the componentsof insertion tube 20′ as described above to provide a sterility barrierand to provide mechanical properties that contribute significantly tothe torsional and/or bending stiffness of insertion tube 20, 20′. Forexample, outer sheath 56 may provide 20-50% of the overall bendingstiffness of fully assembled insertion tube 20.

Flexible endoscope 15 includes a handle 40 connected to proximal endconnector 39 of insertion tube 20. Handle 40 is also connectable toinsertion tube 20′ or any other interchangeable members of an endoscopefamily having a common connector 39. One or more proximal IMUs 44 may bedisposed in handle 40 and/or in connector 39 at the proximal end ofinsertion tube 20, as shown in FIGS. 1 and 5 . A battery 41 may bemounted in handle 40 as shown. Optionally, electrical power may beprovided to endoscope 15 via an electrical cable similar to cable 18.Alternatively, handle 40 is releasably connected to the proximal end ofinsertion tube 20. The releasable connection may be a quick-releasetype, such as a quarter-turn fastening or bayonet-type mount and mayincorporate facilitated electrical connections for IMUs 25, 27, 44 andoptical module 22 as well as facilitated mechanical connections betweencables 30 and associated actuators 42.

Handle 40 includes a plurality of actuators 42, each actuator 42 beingoperatively associated with a corresponding cable extending proximallyfrom insertion tube 20. Actuators 42 may be selected from various typesof actuators including linear or rotary, electric (e.g.electro-mechanical), mechanical, hydraulic, pneumatic, twisted andcoiled polymer (TCP) or supercoiled polymer (SCP), thermal or magneticshape memory alloys. A single actuator 42 is shown in FIG. 1 for clarityof illustration, and a connection between actuator 42 and cable 30 isomitted for clarity and because the general concept of actuators andcables will be understood by a person of ordinary skill in the field ofendoscopes.

One or more manually operable controllers, i.e. haptic input devices 43are located on handle 40 for providing force feedback while inputtingelectronic commands for manipulating endoscope physical properties, i.e.for steering and/or adjusting the torsional and bending stiffnesscharacteristics of insertion tube 20. Haptic input devices 43 may be anysuitable type of programmable or pre-programmed kinesthetic or tactilecommunication devices such as magnetoresistive (MR) controls or motorcontrollers with feedback. Haptic devices 43 are illustrated as rotarycontrols that may simulate the steering wheels found on conventionalendoscopes. Alternatively, other haptic input devices may beincorporated into handle 40 such as joysticks, touchpads, or keypads,etc. In another alternative embodiment, endoscope system 10 may includehaptic input devices 43′ located separately from handle 40 as shown inFIG. 1 . At the discretion of the clinician, haptic devices 43′ may beused to override any communications from haptic devices 43 on handle 40.In yet another alternative embodiment, input devices 43, 43′ are nothaptic-type devices. Such non-haptic devices can input commands tocomputer 16 for manipulating endoscope physical properties in situationswhere force feedback is not required.

Computer 16 is illustrated as being physically mounted in handle 40.Alternatively, computer 16′ can be located separately from endoscope 15on a conventional endoscopy tower or “stack,” and can communicate withendoscope 15 via cable or data port 18 as shown in FIG. 1 . Computer 16is configured for converting image data received from optical module 22into two-dimensional images displayable on monitor 17. In alternativeembodiments where endoscope 15 has more than one optical module 22,computer 16 is configured for converting image data received from theplurality of optical modules 22 into three-dimensional imagesdisplayable on monitor 17.

Ideal handling characteristics of an endoscope are dependent on thetortuosity of the anatomy. For ideal handling, the rigidity, flexibilityand torsional requirements will be different for tighter anatomic turnsfrom the requirements for milder anatomic turns. Computer 16 isconfigured for steering and/or adjusting torsional and bending stiffnesscharacteristics of insertion tube 20 by driving the plurality ofactuators 42 in response to a) one or more command inputs from the oneor more haptic input devices 43, and/or b) data from distal IMU(s) 25and intermediate IMU 27 identifying directional changes as insertiontube distal end 21 is pushed through the anatomy of the living body.Each discrete anatomic bend can be characterized by distal IMU(s) 25 andintermediate IMU 27 according to parameters such as bend length, angleof bend, and distance from prior bend. This data from distal IMU(s) 25and intermediate IMU 27 can then be used by computer 16 to automaticallyand dynamically adjust bending stiffness and torsional characteristicsto pre-defined specification ranges. During endoscopy, if distal IMU(s)25 and/or intermediate IMU 27 do not register forward movement ofinsertion tube distal end 21 despite movement registered in proximalIMU(s) 44, then computer 16 may drive actuators 42 as necessary toadjust the bending stiffness and torsional characteristics of insertiontube 20 to facilitate forward movement of insertion tube distal end 21.Should forward movement of insertion tube distal end 21 be detected bydistal IMU(s) 25 and intermediate IMU 27 in response to the adjustments,computer 16 will save data regarding the anatomical bend and bendingstiffness/torsional characteristics in a memory function for futurealgorithm refinement.

Computer 16 is configured for creating a digital three-dimensionalanatomy model by combining position and orientation data received fromone or more IMUS 25, 27 and/or 44 and image data received from opticalmodule 22. The image data received from optical module 22 comprises aplurality of image frames and the spatial pose data received from distalIMU 25 comprises discrete distal IMU pose data points, as measured bydistal IMU 25 and/or intermediate IMU 27, sequentially arranged along apath traced through the living body by the insertion tube distal end 21.Computer 16 creates a digital three-dimensional or spatial image map foran anatomy model by associating each image frame or a sampling of imageframes with a discrete distal IMU pose data point to create a discreteimage pose datum. Each image pose datum is stored by computer 16 as a) anew reference and b) relative to prior references. As the path isre-traced through the living body by the insertion tube distal end,computer 16 replaces orientation data previously received from distaland proximal IMUs 25, 27 and/or 44 and replaces image data previouslyreceived from optical module 22. Computer 16 progressively stitchestogether each image frame or sampling of image frames from opticalmodule 22 using the associated pose data point from distal IMU 25 toorientate the frames in a set of three-dimensional planes surroundingthe path thereby creating a three-dimensional or spatial image map ofthe anatomy displayable as an endoluminal rendering on monitor 17. Sincethe rendered image derived from the three-dimensional or spatial imagerepresentation contains historical spatial data from distal IMUs 25associated with each image frame and distal IMU 25 contains the currentpose of insertion tube distal end 21 as well as information about theflexing tip of the endoscope, the current pose of insertion tube distalend 21 as well as the flexing tip can be referenced on thethree-dimensional or spatial image model in real-time, thus enablingauxiliary portrayals of the anatomy to enable better understanding ofthe endoscope tip location and orientation. The overall path of theanatomy is discerned from the time series of the IMU poses with theimage data surrounding these path points being available for display asneeded to enhance understanding of anatomy being explored. Computer 16can create an external representation of the approximate spatial path ofthe anatomy that can be shown simultaneously with video images fromoptical module 22.

If additional data regarding the measured distance from the distal end21 to the anatomy surface is obtained, then computer 16 may portray thecurrent location and orientation of insertion tube distal end 21superimposed on an endoluminal rendering of the three-dimensionalsurface anatomy model on monitor 17. The distance from the distal end 21to the anatomy surface may be measured by incorporating stereo cameras,a structured-light three-dimensional scanner using projected lightpatterns, or a time-of-flight range-imaging camera (none of which areshown).

Computer 16 is also configured to provide the one or more manual rotarycontrols with kinesthetic or haptic communication relative to thetensile load applied by the one or more of the actuators to thecorresponding cables. This haptic communication may be driven bycomputer 16 to emulate the manual feel of operating the steering wheelsof a conventional, strictly mechanical endoscope. Emulation may beachieved by computer 16 by reference to a) calibration data forinsertion tube 20, and/or b) pre-defined specifications, e.g. a seriesof pre-defined ratios of kinesthetic or haptic feedback to insertiontube kinematic outputs.

Calibration data may be associated with an individual insertion tube 20,as measured or determined during manufacturing, or calibration data maygenerally extend to a series or family of identical insertion tubes 20along with their corresponding flexible tip sections 50. A memory module45 containing calibration data may optionally be disposed withininsertion tube 20, as shown in FIG. 1 as being located near the proximalend of insertion tube 20. For endoscopes 15 where handle 40 isreleasably connected to insertion tube 20, computer 16 may set upspecific emulation handling parameters based upon the calibration dataread from memory module 45 in the connected insertion tube 20.Alternatively, the calibration data could be stored on board theinsertion tube 20 as a quick response code (QR code) or similar barcodewhere the meaning of the code is either known to computer 16 or can belooked up via a network. In such an arrangement, handle 40 may include asuitable code reader adapted to view the QR code before, after, orduring the connection of insertion tube 20 and handle 40, i.e. viaconnector 39.

As an example of a method of determining calibration data for aninsertion tube 20, insertion tube 20 is manufactured and placed in atesting rig to determine how many rotations of a haptic rotary inputdevice it takes to achieve flexion and torsion targets. These rotationsare saved and stored on memory module 45 in insertion tube 20 and areused to calibrate the number of turns a haptic device 43 on thehandpiece must turn in order to move insertion tube 20 to a consistentand predictable position. Thus, calibration data is indicative of thephysical properties of an insertion tube 20. For example, if (input of)2 turns in a manufacturing test rig are required to achieve a 180° bend(output) of insertion tube 20, but a pre-defined usage standard says a180° bend should only require 1.5 turns, then the calibration datastored in memory module 45 will inform computer 16 to modify commandinputs such that each turn of rotary input device 43 by a clinical userwould actually make the associated actuator move 1.25 times (2/1.5).

Thus, computer 16 is configured to perform the following steps:

-   -   receive input commands from the one or more haptic rotary input        devices 43,    -   modify the input commands with reference to the calibration data        readable in memory module 45, and    -   use the modified input commands to drive the plurality of        actuators and thereby operate the corresponding cables to        consistently achieve a pre-defined ratio of rotary control        rotation inputs to insertion tube kinematic outputs.

In alternative embodiments, the haptic input devices may be other thanrotary controllers. In such embodiments, the inputs would involvemeasures of motion in joysticks, movement of fingers on touchpads, orkeyboard entries, etc. In one embodiment, computer 16 can drive theactuators to emulate a pre-defined manual sensation or feel of thedevice controls rather than, as in the above example, achieve anexpected number of rotations to generate a certain bend in insertiontube 20. In this case, computer 16 uses the modified input commands todrive the plurality of actuators and thereby operate the correspondingcables to consistently achieve a pre-defined ratio of kinesthetic hapticfeedback to insertion tube kinematic outputs. With the above methods, asemi-robotic endoscope using the present technology can emulate themanual feel of a conventional strictly manual endoscope, thus requiringminimal training of a clinician accustomed to conventional devices.

The computer 16 may comprise a processor and a computer-readable storagemedium that stores instructions that when executed by the processor,carry out the functions attributed to the computer 16 as describedherein. Although not required, aspects and embodiments of the presenttechnology can be described in the general context ofcomputer-executable instructions, such as routines executed by ageneral-purpose computer, e.g., a server or personal computer. Thoseskilled in the relevant art will appreciate that the present technologycan be practiced with other computer system configurations, includingInternet appliances, hand-held devices, wearable computers, cellular ormobile phones, multi-processor systems, microprocessor-based orprogrammable consumer electronics, set-top boxes, network PCs,mini-computers, mainframe computers and the like. The present technologycan be embodied in a special purpose computer or data processor that isspecifically programmed, configured or constructed to perform one ormore of the computer-executable instructions explained in detail below.Indeed, the term “computer” (and like terms), as used generally herein,refers to any of the above devices, as well as any data processor or anydevice capable of communicating with a network, including consumerelectronic goods such as game devices, cameras, or other electronicdevices having a processor and other components, e.g., networkcommunication circuitry. Data processors include programmablegeneral-purpose or special-purpose microprocessors, programmablecontrollers, application specific integrated circuits (ASICs),programmable logic devices (PLDs), or the like, or a combination of suchdevices. Software may be stored in memory, such as random-access memory(RAM), read-only memory (ROM), flash memory, or the like, or acombination of such components. Software may also be stored in one ormore storage devices, such as magnetic or optical based disks, flashmemory devices, or any other type of non-volatile storage medium ornon-transitory medium for data. Software may include one or more programmodules which include routines, programs, objects, components, datastructures, and so on that perform particular tasks or implementparticular abstract data types.

The present technology can also be practiced in distributed computingenvironments, where tasks or modules are performed by remote processingdevices, which are linked through a communications network, such as aLocal Area Network (“LAN”), Wide Area Network (“WAN”), or the Internet.In a distributed computing environment, program modules or sub-routinesmay be located in both local and remote memory storage devices. Aspectsof the present technology described herein may be stored or distributedon computer-readable media, including magnetic and optically readableand removable computer discs, stored as in chips (e.g., EEPROM or flashmemory chips), etc. Alternatively, aspects of the present technology maybe distributed electronically over the Internet or over other networks(including wireless networks). Those skilled in the relevant art willrecognize that portions of the present technology may reside on a servercomputer, while corresponding portions reside on a client computer. Datastructures and transmission of data particular to aspects of the presenttechnology are also encompassed within the scope of the presenttechnology.

EXAMPLES

Several aspects of the present technology are set forth in the followingexamples.

-   -   1. An endoscope comprising:    -   a flexible elongate insertion tube having a deflectable distal        end, a proximal end connected to a handle, and an intermediate        flexible segment therebetween;    -   an intermediate inertial measurement unit (IMU) disposed at the        distal end of the intermediate segment;    -   an optical module disposed at the insertion tube distal end and        adapted to receive images of a body cavity of a living body;    -   one or more distal IMUs disposed at the insertion tube distal        end; and    -   a plurality of cables extending proximally through the insertion        tube from corresponding anchor points at the insertion tube        distal end;    -   wherein the handle comprises:        -   a plurality of actuators, each actuator being operatively            associated with a corresponding cable;        -   one or more haptic input devices for inputting commands for            manipulating the physical properties of the insertion tube;            and        -   a computer configured for:            -   steering and/or adjusting torsional and bending                stiffness characteristics of the insertion tube by                driving the plurality of actuators in response to one or                more command inputs from the one or more haptic input                devices;            -   creating a digital three-dimensional image                representation of an anatomy model by combining position                and orientation data received from the distal and                intermediate IMUs and image data received from the                optical module;            -   converting image data received from the optical module                into two-dimensional images displayable on a monitor                extrinsic to the endoscope; and            -   facilitating handling properties of the endoscope by                driving the plurality of electro-mechanical actuators to                automatically and dynamically adjust torsional and                bending stiffness characteristics of the insertion tube                to correspond to the tortuosity of the anatomy model.    -   2. The endoscope of example 1 wherein the image data received        from the optical module comprises a plurality of image frames        and the position and orientation data received from the distal        and intermediate IMUs comprises discrete distal IMU pose data        points sequentially arranged along a path traced through the        living body by the insertion tube distal end; and        -   wherein creating a digital three-dimensional spatial image            representation further comprises:        -   associating each image frame or a sampling of image frames            with a discrete distal IMU pose data point to create a            discrete image pose datum; and        -   storing each image pose datum as a) a new reference and b)            relative to prior references.    -   3. The endoscope of example 2 wherein creating a digital        three-dimensional spatial image representation further        comprises, as the path is re-traced through the living body by        the insertion tube distal end, replacing pose data previously        received from the distal and proximal IMUs and replacing image        data previously received from the optical module.    -   4. The endoscope of example 2 wherein creating a digital        three-dimensional spatial image representation further comprises        progressively stitching together each image frame or sampling of        image frames using the associated pose data point to locate and        orientate the frames in a set of three-dimensional planes        surrounding the path thereby creating the three-dimensional        spatial image representation displayable as an endoluminal        rendering on an extrinsic monitor.    -   5. The endoscope of example 4 wherein the computer is further        configured for portraying the current location and orientation        of the insertion tube distal end superimposed on an endoluminal        rendering of the three-dimensional spatial image representation        on an extrinsic monitor.    -   6. The endoscope of example 1 wherein the insertion tube        proximal end is releasably connected to the handle.    -   7. The endoscope of example 1 wherein the computer is further        configured to provide the one or more input devices with        kinesthetic haptic feedback relative to the tensile load applied        by the one or more of the actuators to the corresponding cables.    -   8. The endoscope of example 7 wherein the haptic feedback is        controlled by the computer to emulate the manual feel of        operating a strictly mechanical endoscope.    -   9. An endoscope system comprising:    -   an endoscope having:        -   a flexible elongate insertion tube having a distal end, a            proximal end connected to a handle, and an intermediate            flexible segment therebetween;        -   an intermediate inertial measurement unit (IMU) mounted at            the distal end of the intermediate segment;        -   an optical module disposed at the insertion tube distal end            and adapted to receive images of a body cavity of a living            body;        -   one or more distal IMUs disposed at the insertion tube            distal end; and        -   a plurality of cables extending proximally through the            insertion tube from corresponding anchor points at the            insertion tube distal end;        -   wherein the handle comprises:            -   a plurality of actuators, each actuator being                operatively associated with a corresponding cable;            -   one or more haptic input devices for inputting commands                for manipulating the physical properties of the                insertion tube; and            -   a computer configured for:                -   steering and/or adjusting torsional and bending                    stiffness characteristics of the insertion tube by                    driving the plurality of actuators in response to                    one or more command inputs from the one or more                    controls;                -   creating a digital three-dimensional spatial image                    representation by combining pose data received from                    the distal and proximal IMUs and image data received                    from the optical module;                -   converting image data received from the optical                    module into two-dimensional images displayable on a                    monitor; and                -   facilitating handling properties of the endoscope by                    driving the plurality of electro-mechanical                    actuators to automatically and dynamically adjust                    torsional and bending stiffness characteristics of                    the insertion tube to correspond to the tortuosity                    of the anatomy model in accordance with pre-defined                    specifications.    -   10. An endoscope comprising:    -   a flexible elongate insertion tube having a distal end and a        proximal end releasably connected to a handle;    -   an optical module disposed at the insertion tube distal end and        adapted to receive images of an interior of a living body;    -   a plurality of cables extending proximally through the insertion        tube from corresponding anchor points at the insertion tube        distal end; and    -   a memory module disposed within the insertion tube and        containing calibration data;    -   wherein the handle comprises:        -   a plurality of electro-mechanical actuators, each actuator            being operatively associated with a proximal end of a            corresponding cable;        -   one or more manually operable rotary controllers for            inputting commands for manipulating the insertion tube            physical properties; and        -   a computer configured for:            -   receiving input commands from the one or more                controllers;            -   modifying the input commands with reference to the                calibration data; and            -   using the modified input commands to drive the plurality                of actuators and thereby operating the corresponding                cables to consistently achieve a pre-defined ratio of                controller rotations to insertion tube kinematic                outputs.    -   11. The endoscope of example 10 wherein the calibration data is        indicative of the physical properties of the insertion tube.    -   12. The endoscope of example 11 wherein the physical properties        of the insertion tube are measurable at the time of manufacture.    -   13. The endoscope of example 10 wherein the pre-defined ratio of        controller rotations to insertion tube kinematic outputs        emulates the manual feel of operating a strictly mechanical        endoscope.    -   14. An endoscope comprising:    -   a flexible elongate insertion tube having a distal end and a        proximal end releasably connected to a handle;    -   an optical module disposed at the insertion tube distal end and        adapted to receive images of an interior of a living body;    -   a plurality of cables extending proximally through the insertion        tube from corresponding anchor points at the insertion tube        distal end; and    -   a means of storing calibration data within the insertion tube;    -   wherein the handle comprises:        -   a plurality of electro-mechanical actuators, each actuator            being operatively associated with a proximal end of a            corresponding cable;        -   one or more haptic input devices for inputting commands for            manipulating the insertion tube physical properties; and        -   a computer configured for:            -   receiving input commands from the one or more input                devices;            -   modifying the input commands with reference to the                calibration data; and            -   using the modified input commands to drive the plurality                of actuators and thereby operating the corresponding                cables to consistently achieve a pre-defined ratio of                haptic device kinesthetic feedback to insertion tube                kinematic outputs.    -   15. The endoscope of example 14 wherein the pre-defined ratio of        haptic device kinesthetic feedback to insertion tube kinematic        outputs emulates the manual feel of operating a strictly        mechanical endoscope.    -   16. A method of using an endoscope comprising:    -   inserting an elongate flexible insertion tube into a pathway in        a patient's body; and    -   operating one or more input devices disposed on a handle to        manipulate physical properties of the insertion tube via a        computer.    -   17. The method of example 16 further comprising receiving force        feedback via the one or more input devices regarding the        physical properties of the insertion tube and/or contact forces        between the insertion tube and the pathway in the patient's        body.    -   18. The method of example 16 further comprising viewing an image        on a monitor, the image being created by the computer using data        received from an optical module disposed at a distal end of the        insertion tube.    -   19. The method of example 18 wherein,    -   the image on the monitor is a three-dimensional image        representation of an anatomy model; and    -   wherein the computer additionally uses position and orientation        data received from one or more inertial measurement units (IMUs)        disposed in the insertion tube to create the image.    -   20. A computer-readable storage medium storing instructions        that, when executed by a computing system, cause the computing        system to perform operations for performing a method of        operation in an endoscopic system, the instructions comprising:    -   receiving position and orientation data from a distal inertial        measurement unit (IMU) positioned at a deflectable distal end        portion of an endoscope;    -   receiving position and orientation data from an intermediate IMU        positioned at an intermediate flexible portion of the endoscope;        and    -   based on the position and orientation data from the distal and        intermediate IMUs, driving a plurality of electro-mechanical        actuators of the endoscope to dynamically adjust torsional        and/or bending stiffness characteristics of the deflectable        distal end portion and/or the intermediate flexible portion of        the endoscope.    -   21. The computer-readable storage medium of example 20 wherein        the instructions further comprise:    -   generating a digital three-dimensional image representation of        an anatomy model by combining the position and orientation data        received from the distal and intermediate IMUs; and    -   wherein driving the plurality of electro-mechanical actuators of        the endoscope includes driving the plurality of        electro-mechanical actuators to dynamically adjust torsional        and/or bending stiffness characteristics of the deflectable        distal end portion and/or the intermediate flexible portion of        the endoscope to correspond to a tortuosity of the anatomy        model.    -   22. The computer-readable storage medium of example 20 wherein        the instructions further comprise:    -   receiving image data of a body cavity of a living body from an        optical module positioned at the deflectable distal end portion        of the endoscope; and    -   converting the image data received from the optical module into        two-dimensional images displayable on a monitor.    -   23. The computer-readable storage medium of example 22 wherein        the instructions further comprise creating a digital        three-dimensional image representation of the body cavity by        combining (a) the position and orientation data received from        the distal and intermediate IMUs and (b) the image data received        from the optical module.

The above detailed descriptions of embodiments of the technology are notintended to be exhaustive or to limit the technology to the precise formdisclosed above. Although specific embodiments of, and examples for, thetechnology are described above for illustrative purposes, variousequivalent modifications are possible within the scope of thetechnology, as those skilled in the relevant art will recognize. Forexample, while steps are presented in a given order, alternativeembodiments may perform steps in a different order. Moreover, thevarious embodiments described herein may also be combined to providefurther embodiments. Reference herein to “one embodiment,” “anembodiment,” or similar formulations means that a particular feature,structure, operation, or characteristic described in connection with theembodiment can be included in at least one embodiment of the presenttechnology. Thus, the appearances of such phrases or formulations hereinare not necessarily all referring to the same embodiment.

Moreover, unless the word “or” is expressly limited to mean only asingle item exclusive from the other items in reference to a list of twoor more items, then the use of “or” in such a list is to be interpretedas including (a) any single item in the list, (b) all of the items inthe list, or (c) any combination of the items in the list. Where thecontext permits, singular or plural terms may also include the plural orsingular term, respectively. Additionally, the term “comprising” is usedthroughout to mean including at least the recited feature(s) such thatany greater number of the same feature and/or additional types of otherfeatures are not precluded. Directional terms, such as “upper,” “lower,”“front,” “back,” “vertical,” and “horizontal,” may be used herein toexpress and clarify the relationship between various elements. It shouldbe understood that such terms do not denote absolute orientation.Further, while advantages associated with certain embodiments of thetechnology have been described in the context of those embodiments,other embodiments may also exhibit such advantages, and not allembodiments need necessarily exhibit such advantages to fall within thescope of the technology. Accordingly, the disclosure and associatedtechnology can encompass other embodiments not expressly shown ordescribed herein.

1.-26. (canceled)
 27. An endoscope system comprising: a flexibleelongate insertion tube having a deflectable distal end and a proximalend; an optical module disposed at the distal end of the insertion tubeand adapted to receive images of a body cavity of a living body; one ormore inertial measurement units (IMUS) disposed within the insertiontube; a plurality of cables extending proximally through the insertiontube from corresponding anchor points at the distal end of the insertiontube; a handle releasably connected to the proximal end of the insertiontube, the handle including a plurality of electro-mechanical actuators,each actuator being operatively associated with a corresponding cable ofthe plurality of cables extending through the insertion tube, and one ormore haptic devices for inputting commands for manipulating physicalproperties of the insertion tube; and a computer configured to:manipulate physical properties of the insertion tube by driving theplurality of electro-mechanical actuators in response to one or morecommand inputs from the one or more haptic devices, and convert theimage data received from the optical module into two-dimensional imagesdisplayable on a monitor, wherein dynamic and automatic adjustment ofthe plurality of electro-mechanical actuators via the computer isachieved as a response to position and orientation data received fromthe one or more IMUS.
 28. The endoscope system of claim 27, wherein thecomputer is further configured to provide the one or more haptic deviceswith kinesthetic haptic feedback relative to a tensile load applied bythe plurality of electro-mechanical actuators to the correspondingcables.
 29. The endoscope system of claim 27, wherein the computer isfurther configured to drive one or more of the plurality ofelectro-mechanical actuators in response to the one or more commandinputs from the one or more haptic devices to achieve a pre-definedratio of measured haptic device input motions to insertion tubekinematic outputs.
 30. The endoscope system of claim 27, wherein the oneor more IMUs comprise: one or more distal IMUs disposed at the distalend of the insertion tube; one or more intermediate IMUs disposed atalong a length of the insertion tube; and one or more proximal IMUsdisposed in the handle and/or in a connector at the proximal end of theinsertion tube; and wherein the computer is further configured to createa digital three-dimensional image representation of an anatomy model bycombining position and orientation data received from the one or moredistal, intermediate, and/or proximal IMUs, and image data received fromthe optical module, and to further combine the position and orientationdata received from the one or more distal, intermediate, and/or proximalIMUs into the creation of the digital three-dimensional imagerepresentation of the anatomy model.
 31. The endoscope system of claim30, wherein the image data received from the optical module comprises aplurality of image frames and wherein the position and orientation datareceived from the one or more IMUs comprises discrete IMU pose datapoints sequentially arranged along a path traced through the living bodyby the distal end of the insertion tube; and wherein the computer isfurther configured to create the digital three-dimensional imagerepresentation by: associating each image frame or a sampling of imageframes with a discrete IMU pose data point to create a discrete imagepose datum; and storing each image pose datum as a) a new reference andb) relative to prior references.
 32. The endoscope system of claim 31,wherein the computer is further configured to create the digitalthree-dimensional image representation by, as the path is re-tracedthrough the living body by the distal end of the insertion tube,replacing pose data previously received from the one or more IMUs andreplacing the image data previously received from the optical module.33. The endoscope system of claim 31, wherein the computer is furtherconfigured to create the digital three-dimensional image representationby progressively stitching together each image frame or sampling ofimage frames using the associated pose data point to locate andorientate the frames in a digital three-dimensional or spatial image mapsurrounding the path thereby creating the three-dimensional imagerepresentation displayable as an endoluminal rendering on the monitor.34. The endoscope system of claim 31, wherein the computer is furtherconfigured for portraying a current location and orientation of thedistal end of the insertion tube superimposed on an endoluminalrendering of the three-dimensional image representation on the monitor.35. An endoscope system comprising: an elongate insertion tube having adistal end and a proximal end; a handle releasably connected to theproximal end of the insertion tube, the handle including a plurality ofelectro-mechanical actuators; one or more optical modules disposed atthe distal end of the insertion tube and adapted to receive images of abody cavity of a living body; one or more inertial measurement units(IMUs) disposed in the insertion tube; and a computer configured toprovide dynamic and automatic adjustment of one or more of the pluralityof electro-mechanical actuators, achieved as a response to position andorientation data received from the one or more IMUs.
 36. The endoscopesystem of claim 35, wherein the one or more IMUs comprise: one or moredistal IMUs disposed in the insertion tube distal end; one or moreintermediate IMUs disposed along a length of the insertion tube; and oneor more proximal IMUs disposed in the handle and/or in a connector atthe proximal end of the insertion tube; wherein the computer is furtherconfigured to: combine the position and orientation data received fromthe one or more distal, intermediate, and/or proximal IMUs, and imagedata received from the one or more optical modules to create a digitalthree-dimensional image representation of an anatomy model displayableon a monitor; and facilitate handling properties of the insertion tubebody by driving one or more of the plurality of electro-mechanicalactuators to dynamically and automatically adjust torsional and bendingstiffness characteristics of the insertion tube to pre-definedspecification ranges which correspond to a tortuosity of the anatomymodel.
 37. The endoscope system of claim 36, wherein the image datareceived from the one or more optical modules comprises a plurality ofimage frames and wherein the position and orientation data received fromthe one or more distal IMUs and the intermediate IMUs comprises discreteIMU pose data points sequentially arranged along a path traced throughthe living body by the distal end of the insertion tube; and wherein thecomputer is further configured to create the digital three-dimensionalimage representation by: associating each image frame or a sampling ofimage frames with a discrete IMU pose data point to create a discreteimage pose datum; and storing each image pose datum as a) a newreference and b) relative to prior references.
 38. The endoscope systemof claim 37, wherein the computer is further configured to create thedigital three-dimensional image representation by, as the path isre-traced through the living body by the distal end of the insertiontube, replacing pose data previously received from the one or more IMUsand replacing the image data previously received from the one or moreoptical modules.
 39. The endoscope system of claim 37, wherein thecomputer is further configured to create the digital three-dimensionalimage representation by progressively stitching together each imageframe or sampling of image frames using the associated pose data pointto locate and orientate the frames in a digital three-dimensional orspatial image map surrounding the path thereby creating thethree-dimensional image representation displayable as an endoluminalrendering on the monitor.
 40. The endoscope system of claim 37, whereinthe computer is further configured for portraying a current location andorientation of the distal end of the insertion tube superimposed on anendoluminal rendering of the three-dimensional image representation onthe monitor.
 41. A system comprising: a flexible elongate insertiontube; an optical module disposed at a distal end of the insertion tubeand adapted to receive images of a body cavity of a living body along apath traced through the living body by the distal end of the insertiontube; one or more inertial measurement units (IMUs) disposed within theinsertion tube; and a computer configured to create a digitalthree-dimensional image representation of an anatomy model by combiningposition and orientation data received from the one or more IMUs andimage data received from the optical module.
 42. The endoscope system ofclaim 41, wherein the one or more IMUs comprise: one or more distal IMUsdisposed at the distal end of the insertion tube; one or moreintermediate IMUs disposed along a length of the insertion tube; and oneor more proximal IMUs disposed in a handle and/or in a connectorreleasably connected to a proximal end of the insertion tube.
 43. Theendoscope system of claim 41, wherein the computer is further configuredto facilitate handling properties of the insertion tube by driving aplurality of electro-mechanical actuators to dynamically andautomatically adjust torsional and bending stiffness characteristics ofthe insertion tube to pre-defined specification ranges which correspondto a tortuosity of the anatomy model.
 44. The endoscope system of claim41, wherein the computer is further configured to portray a currentlocation and orientation of the distal end of the insertion tubesuperimposed on an endoluminal rendering of the three-dimensional imagerepresentation on a monitor.
 45. The system of claim 41, wherein theimage data received from the optical module comprises a plurality ofimage frames, and the position and orientation data includes discreteIMU pose data points sequentially arranged along the path traced throughthe living body by the distal end of the insertion tube; and thecomputer is further configured to: create the digital three-dimensionalimage representation of the anatomy model by associating each imageframe from the plurality of image frames with a discrete IMU pose datapoint to create a discrete image pose datum; and store each image posedatum as a) a new reference and b) relative to prior references.
 46. Theendoscope system of claim 45, wherein the computer is further configuredto create the digital three-dimensional image representation by, as thepath is re-traced through the living body by the distal end of theinsertion tube, replacing pose data previously received from the one ormore IMUs and replacing the image data previously received from theoptical module.
 47. The endoscope system of claim 45, wherein thecomputer is further configured to create the digital three-dimensionalimage representation by progressively stitching together each imageframe or sampling of image frames using the associated pose data pointto locate and orientate the frames in a digital three-dimensional orspatial image map surrounding the path thereby creating thethree-dimensional image representation displayable as an endoluminalrendering on a monitor.